Artifacts and organism mimickers in pathology: Case examples and review of literature

Despite the impressive advances in pathology and microbiology of recent years, the morphologic recognition of an organism remains a major component in rendering a specific diagnosis of an infectious process, or at minimum, a trigger in the process of identifying an infectious agent. Artifacts and mimickers may pose difficulty to the unwary, and may cause a potential "wild goose chase" that can result in wasted valuable time and resources. Fibrin, collagen exogenous fibers, and bacteria may mimic fungal hyphae. Morphologically altered or treated bacteria and Russel bodies may be mistaken for fungal yeasts, etc. Examples of artifacts and mimickers that may simulate infectious organisms are presented in this article. In addition, a review of literature on the subject, demonstrating a surprising dearth of published articles, despite the frequent encounters of this issue in the daily practice.